ArticleFrontiers in immunology2026
Sintilimab-associated hemophagocytic lymphohistiocytosis: a case report.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a rare hematologic syndrome characterized by massive, uncontrolled cytokine release, which can lead to multiple organ failure and is associated with a high mortality rate. Recent studies have found that checkpoint inhibitors (ICIs) can induce HLH. This case report describes a 75-year-old man with metastatic esophageal squamous cell carcinoma (ESCC) who developed sintilimab-associated HLH, presenting as refractory fever and respiratory symptoms initially misdiagnosed as infection. The diagnosis, confirmed via elevated ferritin, sCD25, and reduced NK-cell activity, was delayed due to nonspecific symptoms. Following the initiation of dexamethasone, the patient's symptoms resolved and laboratory parameters normalized, leading to complete remission. The case highlights HLH as a rare but life-threatening immune-related adverse event of checkpoint inhibitors, underscores the importance of early multidisciplinary discussion (MDT) in patients with unexplained fever, and demonstrates the early diagnosis and treatment are critical.
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